Western states band together to issue vaccine guidelines after CDC and HHS purge

Four western states are issuing their own joint recommendations for Covid, flu and RSV vaccines this fall, providing a counterbalance in anticipation of new vaccine guidance from the Trump administration, which has purged prominent scientists from the federal health department and appointed vaccine skeptics and critics to key roles.

Simultaneously, Susan Monarez, the recently fired director of the Centers for Disease Control and Prevention (CDC), testified to Congress that she feared that under Robert F Kennedy Jr, there was “a real risk that recommendations could be made restricting access to vaccines for children and others in need, without rigorous scientific review”. “If vaccine protections are weakened, preventable diseases will return,” Monarez testified.

The new guidelines from California, Oregon, Washington and Hawaii (COWH), which have formed what they call the West Coast Health Alliance, urge Americans to get this year’s Covid-19 vaccine if they are pregnant, age 65 or older, have a range of risk factors or simply “choose protection”. Very young children, from age 23 months to six, should also receive this year’s Covid vaccine, the states recommend, as should older children and teenagers who have risk factors or have not been vaccinated before.

The western states’ recommendations contrast with the Trump administration’s current Covid-19 vaccine guidelines. In what experts called an unprecedented move, Kennedy, one of the US’s most prominent vaccine skeptics, announced in May that the federal government was no longer recommending that pregnant people and children receive the Covid-19 vaccine.

In contrast with the acting head of Trump’s CDC, a former speechwriter and investment executive with no medical or scientific background, the state health officers who developed the new recommendations “are all medical doctors”, according to a statement from California governor Gavin Newsom. The recommendations are also based on guidance from major health associations, including the American Academy of Pediatrics.

Kennedy purged the existing members of the Advisory Committee on Immunization Practices (ACIP) in June, a move the head of one public health association called a “coup”, and replaced them with his own "experts".

Republican senator Dr. Bill Cassidy has spoken out in concern about the risk of rescinding the recommendation for an infant hepatitis B vaccine, arguing that protecting newborns against the virus had been a tremendous success in making Americans healthier.

A spokesperson for Trump’s Department of Health and Human Services defended the ACIP committee, saying it “remains the scientific body guiding immunization recommendations in this country”, and that “HHS will ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic”.

Although Trump officials have claimed that any adult who wants a Covid-19 vaccine will still be able to get one regardless of the federal guidelines, experts say this is “misleading”, and that federal guidelines profoundly shape how insurance companies reimburse the cost of vaccines and how pharmacies provide them, potentially creating serious practical and financial hurdles for Americans who still want to be vaccinated.

Note: text emphasis was added to the above report.